A transcript of high school credits
(Students required to pass the proficiency Tests for high school graduation,
Must submit proof of passing or exemption from these tests.)

Results from the American College Test
(ACT) (Required ONLY for selected academic programs, scholarships and
athletic programs.)

Transfer applicants for full-time
admission are requested to submit:

Items 1-4 as listed above

All college and university transcripts
from previous institutions attended

Note
to International Students: Leave the Social Security Number, State,
Previous State, County, and Previous County fields blank, be sure to
check "No" for US Citizen and put 0 in both fields for Years/Months at current
county. In the High School box fill it in by the example shown
above it (high school name, city, state, graduation year) but make the state
"XX".

NOTE TO
EVERYONE: Fill out the form as complete as possible with as much
information as possible. The more information we have the easier it is to
help YOU the student. Thank you.

Gender

MaleFemale

Optional But Important

This optional information will not be
used in the admissions process. It is requested to meet governmental
affirmative action reporting requirements.

Ethnicity (Please Check One):

Black or African AmericanAmerican Indian or AlaskanAsianHispanic/LatinoWhiteHawaiian or other Pacific Islander2 or more racesInternationalUnknown / Other

Personal Identification

First
Middle
Last

Other Names Used Social
Security Number (XXX-XX-XXXX)

Street Address

City
State
Zip Code

County
Country

Years/months lived at the current
county

Years

Months

Previous county and state
lived at

(if you haven't lived in a different
county and state, then use the current county and state)

Previous County
Previous State

Phone

Email

()
-

Cell Phone

Alternate Email

()
-

US Citizen?

yesno

Are you a veteran of the United States Military?

YesNo

Are you currently in the Reserves/National Guard
or Active Duty?

YesNo

Are you a dependent of a veteran /service member planning on using their
educational benefits? (i.e. Post 9/11 GI Bill, Chapter 35, MyCAA)

YesNo

Birth Date

Month Day Year

Personal Background

Mark only ONE. What is
your highest educational goal at Rio Grande?

To take only selected courses to obtain knowledge for personal interest.To take only selected courses to upgrade skills for current job.To take only selected courses to train for a new career.To transfer to another school before completing a degree or certificate at Rio GrandeTo obtain a certificate at Rio GrandeTo obtain an associate degree at Rio Grande for transfer to another school.To obtain an associate degree at Rio Grande for the job market.To obtain a bachelor's degree at Rio Grande.Unknown

High School Information

Select the state your high school is in
and the 'High School Attended' dropdown will autogenerate

a list of high schools for you to
choose from.

High School location

City

State

High School
Attended
(Open the drop-down list and choose your school)

Year of Graduation(4
digits ex. 2008)

Intended Major at Rio Grande

Intended Minor at Rio Grande

Enrollment Status

Full Time (12 or more hours)Part-Time

Living Arrangements

CommuterResident

Year of Entry

Admissions Category

NewReadmittedTransfer

Other Colleges and Dates of
Attendance, including Rio Grande:

Special Needs or Unusual
Circumstances (optional)

Parent/Guardian

Please select a choice

Name

Same address as student?

yesno

if 'No' then please enter it

Address
City State

By submitting this I certify that all information contained
in this application is correct and complete to the best of my knowledge. I
understand that withholding and/or giving false information on this application
may make me ineligible for admission or later subject to dismissal. If
admitted to the University of Rio Grande, I agree to live in accordance with
the regulations of the institution.

Additionally, I authorize the Admission Office of Rio Grande to obtain my official high school transcripts for the purpose of completing the application/acceptance process.

Following the successful
submission of your application, you will receive an email confirmation.
If you do not receive an email, please contact the Admissions Office at
1-800-282-7201 ext. 7208 to determine if you application was received.

University of Rio Grande
Rio Grande Community College
218 North College Ave.
Rio Grande, OH 45674-3131

1-800-282-7201 (Toll Free)

Furthermore, the University of Rio
Grande and Rio Grande Community College affirm that policies and practices
relating to housing, academic and social life, and employment are applied
without regard to race, color, gender, religion, disability, age, marital
status, national or ethnic origin, socioeconomic status, or political
affiliation. Inquiries in this regard should be directed to the President
to the University of Rio Grande and the Rio Grande Community College.